Diagnostic radiology training for medical students - a Brazilian multicenter survey

ABSTRACT Objective This study aimed to assess diagnostic radiology training and exposure during medical school, from the perspective of medical students in Brazil. Methods In this multicenter study approved by the Institutional Review Board, medical students from multiple universities in Brazil filled out an online questionnaire regarding their perception about diagnostic radiology training during medical school, including knowledge and use of the American College of Radiology Appropriateness Criteria and their confidence level in interpreting common radiological findings. Medical students from different regions of Brazil were sent invitations to participate in the anonymous survey through radiology group emails initiated by radiology professors and a group of ambassadors representing different institutions. Informed consent was obtained electronically at the beginning of the survey. Results The survey demonstrated diagnostic radiology is frequently included in preclinical exams; however, radiology training during medical school was considered inadequate from the medical students´ perspective. Overall, radiological imaging teaching was provided by radiologists for more than half of the survey respondents; however, radiological imaging is frequently shown to students by non-radiologist physicians during case discussion rounds. Moreover, few respondents had a mandatory radiology training rotation during medical school. Conclusion This Brazilian medical student survey demonstrated that from the medical students' perspective, diagnostic radiology is an important subject in clinical practice; however, their radiology training and exposure are overall heterogeneous.

Are We Facing the End of Gross Anatomy Teaching as We Have Known It for Centuries?

The status of anatomy education in undergraduate medical education has dramatically changed over the course of the past century. From the most important and time-consuming component of the preclinical program, anatomy education has reduced in size and status, and yielded in curricular space to accommodate other disciplines and topics. Meanwhile, radiology has become more prominent, as a means to visualize anatomy, not only in clinical care but also in education. For this perspective paper, the authors, all with backgrounds in anatomy, radiology and/or medical education, conducted structured conversations with several academic colleagues with similar backgrounds, reviewed pertinent literature and analyzed the causes of the historical decline of a knowledge domain of medical education, that nevertheless is widely considered essential for medical students and graduates. After this analysis, the authors propose four ways forward. These directions include systematic peer teaching and development of anatomy education as a scholarly domain, further vertical integration with postgraduate medical education, full integration with radiology education, and capitalizing on educational technology. Schools in several industrialized countries have made steps in these directions, which can be further strengthened. In less affluent countries, and in countries with curricula strongly determined by tradition, these steps are less easy to make. To respond to changes in global health and health care, combined with the inevitable technological progress, and international mobility, we believe all schools will move in these directions, slower or faster.

Elevating Radiology Education Research Through a Dedicated Research Fellowship: Adding Professional Identity as Essential for Success.

RATIONALE AND OBJECTIVES: Education research has been undervalued in radiology, with few radiology journals having dedicated space for such research and barriers to production including dedicated time, resources, grant funding, and mentorship. As radiologists, we have an opportunity to study education in our unique learning environments and create more effective ways to teach that are grounded in established education theory, solid assessment methodologies, and a focus on merit as well as worth. MATERIALS AND METHODS: The growth of education research in our field requires a two-pronged approach; We must cultivate leaders in education research from within our specialty, and continue to submit high quality work to radiology journals to increase exposure of the reviewers and readership to education methodologies. RESULTS: We have created the first radiology education research fellowship to this end. This manuscript details the fellowship creation process, the first education research fellow experience, and in-depth analysis of the inaugural year via a qualitative program review. CONCLUSION: We were successful in supporting an inaugural fellow in attaining the knowledge and skills to become a productive education researcher. Beyond this, the fellowship experience was a catalyst in developing her unique professional identity as an education master which will further raise the status of education research in pediatric radiology.

Evaluación de habilidades transversales de comunicación y colaboración a través de un examen clínico objetivo estructurado de radiología de urgencias para residentes de un programa universitario de especialidad en radiología / Assessment of generic skills in communication and collaboration through an objective structured clinical examination in emergency radiology in a university residency program in Chile

Introducción: La Radiología de Urgencias es una unidad de aprendizaje longitudinal a toda la residencia. En ella los residentes se enfrentan a patología de urgencia en distintas modalidades de imagen. Además del dominio cognitivo, los residentes deben desarrollar habilidades de comunicación y colaboración que les permitan enfrentar adecuadamente los turnos de residencia. Previo a incorporarse a los turnos nocturnos, los residentes deben aprobar un Examen Clínico Objetivo Estructurado (ECOE). Propósito: Evaluar competencias de comunicación y colaboración a través de estaciones de ECOE de Radiología de Urgencias aplicado a residentes de 2º año de residencia. Metodología: Se seleccionaron objetivos específicos a evaluar para las competencias de comunicación y colaboración y contenidos de Radiología Abdominal, Osteoarticular y Pediátrica para diseñar tres estaciones de ECOE, las cuales fueron incorporadas en el instrumento de evaluación aplicado el año 2017. Se calcularon porcentajes de logro por estación y tipo de pauta de evaluación. Para evaluar la implementación de las estaciones, se diseñó y aplicó una encuesta de percepción a los residentes. Resultados: Se diseñaron tres estaciones, dos para el rol Comunicador y una para el rol Colaborador. La validez de contenido se aseguró a través de un panel de expertos. Los porcentajes de logro global en las estaciones fluctuaron entre 74,7% y 95,6%. Las estaciones fueron bien evaluadas por parte de los residentes, quienes valoraron la incorporación de competencias diferentes al dominio cognitivo en el instrumento de evaluación. Conclusión: El ECOE permite certificar habilidades transversales como comunicación y colaboración de manera apropiada

Introduction: Emergency radiology (ER) is taught and learned throughout the entire residency. Trainees are exposed to different subspecialties ER cases and through varied imaging techniques. In addition to the "medical expert" domain, residents must develop communication and collaboration skills that will help them during their call schedule. Before they can take night-call, radiology residents must pass an Objective Structured Clinical Examination (OSCE). Purpose: To evaluate communication and collaboration competencies on an ER-OSCE applied to second-year radiology residents. Methods: Specific learning objectives were defined to evaluate communication and collaboration skills in abdominal, musculoskeletal and pediatric ER. Three OSCE stations were designed for this purpose and added to the evaluation instrument in 2017. On each station, resident performance was assessed with a specific template and percentage of goal achievement was calculated. Trainee´s opinion of this new modality was obtained through a perception survey. Results: Three stations were designed, two for the communicator role and one for the collaborator competency. Validity of content confirmed through an expert panel. Percentages of goal achievement on each station varied between 74,7% and 96,6. The new stations were positively evaluated by residents, which valued that competencies other than "medical expert" were being assessed. Conclusion: ER-OSCE allows the appropriate assessment of generic competencies such as communication and collaboration in radiology.

The development of a free radiological anatomy software teaching tool / Desarrollo de un software libre de anatomia radiológica como una herramienta de enseñanza

SUMMARY: The purpose of this research was to develop a free radiological anatomy software for radiologic anatomy education to assist students and professionals in health science. The study was divided into two phases: image acquisition and software development. The first phase was to obtain plain radiographic images and computed tomographic (CT) scans of an anthropomorphic phantom of head and neck. In addition, plain radiographic images of an anthropomorphic phantom of the chest were obtained. The second phase was the development of the anatomy software as an ImageJ macro. The software was developed through the insertion of the radiologic anatomy landmarks into the images that were obtained and application of multiple choice questions. The software was then tested for usability by getting the professors to answer the multiple choice questions. The software presented radiologic anatomy from 1) Head projections: Waters view, Towne view, Caldwell view, Lateral view, Submentovertex, PA view; 2) Thoracic Spine projections: AP and Lateral View and 3) Chest: PA view, Lateral and Oblique. Tomographic imaging presented one hundred radiologic landmarks of head. In total, there were 354 questions. A final report containing the score of correct answers, as well as the user ID, Date and Time of the test were showed. The test were available in three languages (Spanish, English and Portuguese). A user-friendly and inexpensive software was developed and presented. Students and professionals from several countries are able to practice, repeatedly, the recognition of radiologic anatomical landmarks.

RESUMEN: El propósito de esta investigación fue desarrollar un software gratuito de anatomía radiológica para la educación de anatomía radiológica para ayudar a estudiantes y profesionales de ciencias de la salud. El estudio se dividió en dos fases: adquisición de imágenes y desarrollo de software. La primera fase consistió en obtener imágenes radiográficas simples y tomografías computarizadas (TC) de un fantasma antropomórfico de cabeza y cuello. Además, se obtuvieron imágenes radiográficas simples de un fantasma antropomórfico del tórax. La segunda fase fue el desarrollo del software de anatomía como una macro ImageJ. El software se desarrolló a través de la inserción de los puntos de referencia de la anatomía radiológica en las imágenes que se obtuvieron y la aplicación de preguntas de opción múltiple. Luego, se probó la usabilidad del software haciendo que los profesores respondieran las preguntas de opción múltiple. El software presentó la anatomía radiológica de 1) Proyecciones de la cabeza: vista de aguas, vista de Towne, vista de Caldwell, vista lateral, Submentovertex, vista de PA; 2) proyecciones de la columna torácica: vista AP y lateral y 3) Cofre: vista de PA, lateral y oblicua. Las imágenes tomográficas presentaron cien puntos de referencia radiológica de la cabeza. En total, hubo 354 preguntas. Se mostró un informe final con la puntuación de las respuestas correctas, así como la identificación del usuario, la fecha y la hora de la prueba. Las pruebas estaban disponibles en tres idiomas (español, inglés y portugués). Se desarrolló y presentó un software fácil de usar y de bajo costo. Estudiantes y profesionales de varios países pueden practicar, repetidamente, el reconocimiento de puntos de referencia anatómicos radiológicos.

Facebook as a tool to promote radiology education: expanding from a local community of medical students to all of South America.

OBJECTIVE: To assess the feasibility of Facebook to promote a radiology education project and to expand it from our university community of medical students to a wider audience. MATERIALS AND METHODS: A group of 12 medical students created a Facebook page in June 2015, to contribute to radiology education in our university. From August 2015, clinical cases, including a brief explanation of clinical findings, along with different imaging modalities, were posted weekly and subscribers were encouraged to choose the most appropriate diagnosis. All cases were followed by the appropriate answer and an explanation to highlight imaging findings and diagnosis. Aiming to reach a larger audience, we also shared cases to a public Latin-American Facebook group, comprising a collective total of 28,182 physicians and medical students. Using the Facebook Insights tracking tool, we prospectively analyzed subscriber interaction with our page for 14 months. RESULTS: During the period analyzed, 35 cases were posted. The most common imaging modalities were X-ray (n = 15) and computed tomography (n = 13). Before we began posting the weekly cases, our page had 286 likes. By October 2016, that number had grown to 4244, corresponding to an increase of 1484% and eight times the size of the medical student community at our institution (n = 530). Medical students made up most (76%) of the subscribers, followed by radiology residents (6%). An excellent or moderate contribution to personal image interpretation skills was reported by 65.3% and 33.1% of the users, respectively. CONCLUSION: Creating a Facebook page and posting weekly clinical cases proved to be an effective method of promoting radiology education.

Facebook as a tool to promote radiology education: expanding from a local community of medical students to all of South America / Facebook como uma ferramenta para impulsionar a educação em radiologia: expandindo-se de uma comunidade local de estudantes de medicina para a América do Sul

Abstract Objective: To assess the feasibility of Facebook to promote a radiology education project and to expand it from our university community of medical students to a wider audience. Materials and Methods: A group of 12 medical students created a Facebook page in June 2015, to contribute to radiology education in our university. From August 2015, clinical cases, including a brief explanation of clinical findings, along with different imaging modalities, were posted weekly and subscribers were encouraged to choose the most appropriate diagnosis. All cases were followed by the appropriate answer and an explanation to highlight imaging findings and diagnosis. Aiming to reach a larger audience, we also shared cases to a public Latin-American Facebook group, comprising a collective total of 28,182 physicians and medical students. Using the Facebook Insights tracking tool, we prospectively analyzed subscriber interaction with our page for 14 months. Results: During the period analyzed, 35 cases were posted. The most common imaging modalities were X-ray (n = 15) and computed tomography (n = 13). Before we began posting the weekly cases, our page had 286 likes. By October 2016, that number had grown to 4244, corresponding to an increase of 1484% and eight times the size of the medical student community at our institution (n = 530). Medical students made up most (76%) of the subscribers, followed by radiology residents (6%). An excellent or moderate contribution to personal image interpretation skills was reported by 65.3% and 33.1% of the users, respectively. Conclusion: Creating a Facebook page and posting weekly clinical cases proved to be an effective method of promoting radiology education.

Resumo Objetivo: Avaliar a viabilidade do Facebook em promover um projeto de educação em radiologia da nossa comunidade universitária de estudantes para um público ampliado. Materiais e Métodos: Um grupo de 12 estudantes de medicina criou uma página no Facebook em junho de 2015, como forma de contribuir para a educação em radiologia na nossa universidade. A partir de agosto de 2015, casos clínicos semanais foram postados, incluindo uma breve explicação dos achados clínicos, além de diversas modalidades de imagem, e os assinantes eram encorajados a escolher o diagnóstico mais apropriado. Todos os casos apresentavam uma resposta apropriada e uma explicação para destacar os achados de imagem e o diagnóstico. Com o objetivo de alcançar um público maior, os casos eram também compartilhados em um grupo latino-americano no Facebook, composto de 28.182 médicos e estudantes de medicina. Prospectivamente, analisamos a interação dos assinantes com nossa página durante 14 meses por meio da ferramenta Facebook Insights. Resultados: No período, 35 casos foram postados. Radiografia (n = 15) e tomografia computadorizada (n = 13) foram as modalidades mais comuns. Antes dos casos clínicos semanais, nossa página tinha 286 curtidas. Em outubro de 2016, esse número foi 4244, representando um aumento de 1484%, oito vezes maior do que nossa comunidade estudantil (n = 530). A maioria dos seguidores eram estudantes medicina (76%), seguidos de residentes de radiologia (6%). Os usuários reportaram que o projeto teve grande (65.3%) ou moderada (33.1%) contribuição para as habilidades pessoais de interpretação de imagens. Conclusão: A criação de uma página no Facebook com casos clínicos semanais foi efetiva no auxílio à promoção da educação em radiologia.

Desarrollo de un curriculum de radiología para la formación médica de pregrado: experiencia de una escuela de medicina de Chile / Development of radiology curriculum in undergraduate medical education: experience of a chilean school of medicine

Existe consenso por parte de las autoridades académicas y los estudiantes de Medicina de pregrado que es necesaria la incorporación de la Imagenología a los planes de estudio de la carrera. Sin embargo, esto no se ha traducido en una participación constante de los médicos radiólogos en la formación de los futuros médicos. Nuestra Escuela de Medicina implementó un nuevo plan de estudios el año 2015 el que, entre otros aspectos, acortó la duración de la carrera de 7 a 6 años e integró la Imagenología en forma longitudinal a lo largo de la malla curricular. Para llevar a cabo este proceso de integración curricular fue necesario la decisión departamental y de la Dirección de Pregrado, para así identificar las oportunidades de incorporación de médicos radiólogos en la educación médica de pregrado.

There is wide agreement between teachers, students and authorities in the Schools of Medicine regarding the need of incorporating Medical Imaging teaching for undergraduates. Nonetheless, there is no active nor constant participation of radiologists in teaching for Medicine students. In our Medical School a new program was implemented in 2015, with a duration of 6 years (instead of 7 years, as previously), incorporating Medical Imaging teaching across the curriculum. To achieve the latter objective it was necessary to actively involve the Radiology (Medical Imaging) Department and the Undergraduate Director, identifying the opportunities to incorporate radiologists in medical teaching.

Radiology Abroad: A Global Health Initiative in Guyana.

OBJECTIVE: The purpose of this article is to share our experience conducting a global health outreach initiative in the Radiology Department of the Georgetown Public Hospital in Guyana alongside RAD-AID, a nonprofit organization whose mission is to increase the availability of medical imaging services in developing countries. CONCLUSION: The collaboration between RAD-AID and the Guyanese Ministry of Health has resulted in significant strides for radiology, including the introduction of new resources such as updated sonography and, for the first time, computed tomography for the public sector. In addition, collaboration with the Georgetown Public Hospital has strengthened the clinical management of patients and radiological education of health-care workers in Guyana.

Os Saberes dos Professores e o Ensino da Radiologia no Curso de Graduação em Medicina da UFRJ: Experiência de Vida ou um Simples Exercício da Docência? / Professors Knowledge and the Teaching of Radiology at the Medical School of the Federal University in Rio de Janeiro (UFRJ): a Life Experiência, or Merely a Teaching Exercise?

Resumo: Este trabalho é um relato da experiência que o docente do Departamento de Radiologia da faculdade de Medicina da Universidade Federal do Rio de Janeiro e do Hospital Universitário Clementina Fraga Filho tem com o ensino da disciplina. A partir de entrevistas semi-estruturadas junto aos vinte quatro docentes, através das quais foram coletados os dados que permitiram classificar os diferentes saberes acumulados pelo corpo docente na UFRJ. Concluiu-se com a pesquisa que, os saberes dos professores sempre implicam em uma relação social, seja ela com os seus alunos, seus pares, sua família e com todos que trabalham e convivem direta ou indiretamente no seu cotidiano de ensino.

Abstract: This study reports on the teaching experience of faculty member., at the Department of Radiology, Medical School, Federai University in Rio de janeiro and the Clementina Fraga Filho University Hospital. A semi-structured interview with 24 professors allowed dassifying the different forms of knowledge accumulated by the faculty at the UFRJ. The conclusion was that the professors' knowledge always involved a social relationship, whether with studens, peers, family, and all those who Work and have direct or indirect contact with them in their daily teaching practice.